经阴道彩色多普勒血流显像对侵蚀性葡萄胎诊断价值

目的探讨经阴道彩色多普勒血流显像（TVCDFI）及脉冲多多普勒（PW）对侵蚀性葡萄胎的早期诊断价值及疗效观察。方法对16例临床拟诊侵蚀性葡萄胎患者进行经阴道彩色多普勒超声检查,观察子宫肌壁及宫腔内异常回声的血流特征,对其进行主要血流参数评价,并结合血清绒毛膜促性腺激素（β-HCG）值进行临床疗效观察。结果全部病例TVCDFI均见子宫肌壁的局灶性或弥漫性分布的五彩镶嵌的彩色血流信号区,PW记录到低阻力多样性动脉频谱及静脉性频谱,病灶区动脉血流阻力指数（RI）〈0.40,子宫动脉RI值明显降低,血β-HCG值升高。对化疗敏感病例显示子宫病灶处彩色血流区域逐渐缩小,RI值渐升高,血β-HCG值呈下降趋势,直至恢复正常。结论对可疑葡萄胎患者TVCDFI检查或葡萄胎清宫术后的TVCDFI随访是侵蚀性葡萄胎早期诊断的首选超声检查方式,对观察化疗效果指导临床处理具有重要的意义。

Diagnostic value of Invasive mole using transvaginal color Doppler flow imaging

Objective To investigate the transvaginal color Doppler flow imaging （TVCDFI） and pulsed wave Doppler （PW） for the early diagnosis value and efficacy on invasive mole. Methods 16 patients being iagnosed invasive mole with transvaginal color Doppler ultrasound examination to observe the uterine muscle wall and features of blood flow on abnormal echo within uterine, and the main flow parameters were evaluated, and clinical efficacy was observed to combine with the serum levels of hCG （β-HCG）. Results A local or diffuse abundant blood area within uterine myometrium were seen on TVCDFI of all patients. The uterine artery resistance index （RI） were below 0.40. Dynamic observation cases of chemotherapy-sensitive showed RI values gradually increased, the value of β-HCG showed a downward trend, until the return to normal. Conclusions TVCDFI is the preferred method in early diagnosis of invasive mole and in observing the effect of chemotherapy on the clinical management of the guidance of great significance.